title: Long-term effects on cancer survivors' quality of life of physical training versus physical training combined with cognitive-behavioral therapy: results from a randomized trial.
abstract: BACKGROUND
  We compared the effect of a 12-week group-based multidisciplinary self-management rehabilitation program, combining physical training (twice weekly) and cognitive-behavioral therapy (once weekly) with the effect of 12-week group-based physical training (twice weekly) on cancer survivors' quality of life over a 1-year period.
  
  
  METHODS
  One hundred forty-seven survivors [48.8 +/- 10.9 years (mean +/- SD), all cancer types, medical treatment > or = 3 months ago] were randomly assigned to either physical training (PT, n = 71) or to physical training plus cognitive-behavioral therapy (PT + CBT, n = 76). Quality of life and physical activity levels were measured before and immediately after the intervention and at 3- and 9-month post-intervention using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 questionnaire and the Physical Activity Scale for the Elderly, respectively.
  
  
  RESULTS
  Multilevel linear mixed-effects models revealed no differential pattern in change of quality of life and physical activity between PT and PT + CBT. In both PT and PT + CBT, quality of life and physical activity were significantly and clinically relevantly improved immediately following the intervention and also at 3- and 9-month post-intervention compared to pre-intervention (p < 0.001).
  
  
  CONCLUSIONS
  Self-management physical training had substantial and durable positive effects on cancer survivors' quality of life. Participants maintained physical activity levels once the program was completed. Combining physical training with our cognitive-behavioral intervention did not add to these beneficial effects of physical training neither in the short-term nor in the long-term. Physical training should be implemented within the framework of standard care for cancer survivors.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. a.m.may@umcutrecht.nl
authors.forename: Anne M
authors.initials: AM
authors.lastname: May
authors.forename: Irene
authors.initials: I
authors.lastname: Korstjens
authors.forename: Ellen
authors.initials: E
authors.lastname: van Weert
authors.forename: Bart
authors.initials: B
authors.lastname: van den Borne
authors.forename: Josette E H M
authors.initials: JE
authors.lastname: Hoekstra-Weebers
authors.forename: Cees P
authors.initials: CP
authors.lastname: van der Schans
authors.forename: Ilse
authors.initials: I
authors.lastname: Mesters
authors.forename: Jan
authors.initials: J
authors.lastname: Passchier
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: Wynand J G
authors.initials: WJ
authors.lastname: Ros
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000534:rehabilitation*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care / Q000523:psychology; D017741:Survivors / Q000523:psychology